Off and running?: pregnancy and exercise debates

If you hadn't noticed, I love Paula Radcliffe. As a distance runner myself, Paula has always been one of my very favourite female elite athletes. Now, given her recent New York marathon win, Paula has put pregnancy and exercise back in the headlines. As many pregnant women reading this know, being ‘fit’ is no longer perceived as being incompatible with motherhood and in fact, debates surrounding exercise engages women in a never-ending cycle of bodywork and self-surveillance. For example, the American College of Obstetricians and Gynecologists (ACOG) state that:

Becoming active and exercising at least 30 minutes on most, if not all, days of the week can benefit your health…Regular activity also helps keep you fit during pregnancy and may improve your ability to cope with the pain of labor. This will make it easier for you to get back in shape after the baby is born.

This commonsense approach has been increasingly endorsed by medical professionals after numerous studies investigating the benefits or risks involved in participating in strenuous exercise whilst pregnant. Even though the most recent medical research positions daily exercise as being a necessary component of a ‘healthy’ pregnancy and recommended daily amounts of exercise are closely aligned with those recommended for periods of non-pregnancy, the exercise in pregnancy debate is long-standing. In the existing literature, exercise during pregnancy pregnancy has not generally been associated with miscarriage although the research is largely inconsistent. In one of the largest studies of the link between exercise and pregnancy to date comprising a cohort of almost 93,000 Danish women revealed that certain types of exercise, particularly those marked as ‘high-impact’ were associated with miscarriage.

However, the recommendations are not as easily translated in consideration of the various activities women participate in during daily life. In many cases, a regimented physical exercise programme is much less likely to occur in pregnancy given the multiple demands and competing expectations of pregnant women’s behaviour. As the guidelines for pregnancy exercise have shifted and a number of clinical studies have demonstrated the positive benefits of moderate exercise, such public biomedical exhortations imply that pregnant women should exercise in order to have a healthy pregnancy. Fitness in pregnancy is situated within notions of 'risk', particularly with regard to how pregnant women use their bodies such that ‘fitness’ is increasingly becoming a part of a successful performance of pregnancy. In pregnancy, the attainment and maintenance of a ‘fit, risk-free, flexible, and responsible body’ is the mark of a ‘good’ mother.

Paula Radcliffe has been positioned as both an inspiration for new mums trying to 'bounce back' and also a detriment to mums who feel they could never live up to the training regimen Paula maintained throughout her pregnancy. However, I was pleased to see a great article in the New York Times today discussing the relative safety of running through pregnancy (albeit with some caution). For so long, women have been told that they cannot exercise vigorously in pregnancy for fear of raising their core temperature too high. However, given that pregnant women's blood volume increases at least 20% during pregnancy, some research has shown that this increase is what allows pregnant women to exercise safely and that body temperature should not be as much of a concern. The major concerns with exercising these days in pregnancy are questions of comfort as opposed to capability. Most importantly, numerous studies have shown that exercising in pregnancy is associated with a more positive body sense of self and body image.

In my study,my pregnant informants’ cited three primary motivations for exercising in pregnancy. First, a number of my informants cited body image, feelings of fatness and pressure to lose weight postnatally. The second motivation involves exercise as positively affecting psychological and physical well-being. Thirdly, my pregnant informants cited the need to be ‘fit’ for birth as a primary motivation for exercise. Often women cited a combination of the above three reasons.
How much did you exercise during pregnancy? I'm writing a chapter for my book on this very topic now, so I would love to hear from you.